일개 대학병원에 내원한 무증상성 열공성 뇌경색 환자와 정상인에서 비만 지수와 대사증후군 유병률 비교

정현윤(Hyun Yun Jeong),김도경(Do Kyung Kim),손호영(Ho Yong Son),신윤리(Yoon Ri Shin),이재욱(Jae Wook Lee),김경민(Kyoung Min Kim),김영균(Young Kyun Kim),권정남(Jung Nam Kwon),박선미(Sun Mi Park) 한의병리학회 2010 동의생리병리학회지 Vol.24 No.3

무지 외반증 재발의 한 원인으로 생각되는 종자골 정복에 영향을 주는 인자

윤영필,이철형,정현윤,김영우,정재용,Yune, Young-Phil,Lee, Chul-Hyung,Jeong, Hyun-Yoon,Kim, Young-Woo,Jung, Jae-Yong 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.1

Purpose: The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid. Materials and Methods: The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system. Results: After the proximal chevron osteotomy, the correction of the mean HV angle was $19.5^{\circ}$, and IM angle was $6.2^{\circ}$. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was $9^{\circ}$. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001). Conclusion: We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.

간성뇌병증 환자의 증례 1례

김도경(Do Gyoung Kim),정현윤(Hyun Yun Jeong),이재욱(Jae Wook Lee),신윤리(Yoon Ri Shin),신철경(Cheol Kyung Sin),김경민(Kyung Min Kim),김영균(Young Kyun Kim),이용태(Yong Tae Lee),권정남(Jung Nam Kwon) 한의병리학회 2010 동의생리병리학회지 Vol.24 No.4

무증상성 열공성 뇌경색 환자에서 호모시스테인과 대사증후군의 상관관계에 대한 연구

신윤리,이재욱,이승연,윤용재,정현윤,김경민,김영균,Shin, Yoon-Ri,Lee, Jae-Wook,Lee, Seung-Yeon,Yun, Yong-Jae,Jeong, Hyun-Yun,Kim, Kyoung-Min,Kim, Young-Kyun 대한한방내과학회 2012 大韓韓方內科學會誌 Vol.33 No.3

Objectives : This clinical study was done to examine metabolic syndrome (MS) and plasma homocysteine (HCY) level in patients with silent lacunar infarction (SLI) and in normal controls. Methods : A total of 154 patients, who were over 20 years of age and visited the stroke prevention check-up center of a university hospital from December 2006 to December 2010, were examined by brain CT or brain MRI, and classified into two groups. We compared the components of MS and HCY levels between patients with SLI (n=74) and normal controls (n=80). Modified ATP III definition was used for diagnosis of MS while Korean standard for waist circumference was used. Results : Prevalence of MS was significantly higher in the SLI group than the normal group. HCY was also significantly higher in the SLI group than the noraml, and the odds ratio (OR) for SLI, comparing high HCY level (${\geq}10{\mu}mol/L$) with low HCY level ($<10{\mu}mol/L$), was 3.64 (95% confidence interval (CI); 1.81-7.29, p<.0001). However, there was no correlation between MS and HCY in the SLI group. Prevalence of diabetes and hypertension (HT) was higher in the SLI group than the normal group, but there was no significant difference in blood lipids level between the SLI and normal groups. Of note, HT itself was enough to be an independent risk factor for SLI (OR; 4.58, 95% CI; 1.91-11.01, p=0.001). Body mass index, waist circumference, waist-hip ratio and visceral fat area were significantly higher in the SLI than normal group, and visceral fat area was enough to be an independent risk factor for SLI (OR; 2.41, 95% CI; 1.04-5.59, p=0.040). Conclusions : SLI is shown to have significant correlation with HCY and prevalence of MS, however there is no relationship between HCY and prevalence of MS in patients with SLI.

내측 반월상 연골판 후방 골 기시부 파열의 관절경적 봉합술 후 최소 1년 추시 결과

이철형 ( Chul Hyung Lee ),송인수 ( In Soo Song ),정현윤 ( Hyun Yoon Jeong ),이창수 ( Chang Soo Lee ),이봉주 ( Bong Ju Lee ) 대한스포츠의학회 2011 대한스포츠의학회지 Vol.29 No.1

This study is to evaluate clinical and arthroscopic second-look results of arthroscopic repairs of posterior root tears of medial meniscus which may cause loss of circumferential hoop tension and extrusion of meniscus. From October 2006 to May 2009, fifty-eight patients (59 knees) underwent arthroscopic pull-out repairs. Clinical results were evaluated using Hospital for Special Surgery (HSS) score and International Knee Documentation Committee (IKDC) score for 12-month follow-up. Second-look arthroscopy was done to evaluate meniscal healing in 21 cases. Magnetic resonance imaging (MRI) was performed to assess status of repaired meniscus and tibial tunnel position in 9 patients. Average preoperative HSS score and IKDC score of 59 cases were 69.5 and 36.0, respectively. Average postoperative HSS score and IKDC score of 59 cases had been changed into 90.3 (p<0.001) and 66.8 (p<0.001), respectively. Second-look arthroscopies revealed complete or incomplete healing except one case. Two patients showed increased one grade according to the Kellgren-Lawrence radiologic classification system and others showed no change. Of 9 patients who performed MRI, six patients showed complete healing. The average position of tibial tunnel was 4.8 mm anterior and 5.7 mm medial to center of posterior cruciate ligament. Arthroscopic pull-out repair technique using transtibial tunnel seems to be simple and effective procedure for posterior root tear of medial meniscus. Further evaluation of arthroscopic repair of posterior root tear of medial meniscus should be needed to prove the effectiveness on the prevention of osteoarthritis of knee.

인공 슬관절 전 치환술에서 확인된 내측 반월상 연골판 후방 골기시부 파열의 관련 요인에 대한 분석

송호섭 ( Ho Sup Song ),송인수 ( In Soo Song ),정현윤 ( Hyun Yoon Jeong ),이창수 ( Chang Soo Lee ),이봉주 ( Bong Ju Lee ) 대한슬관절학회 2010 대한슬관절학회지 Vol.22 No.4

목적: 인공 슬관절 전 치환술 도중 내측 반월상 연골판 후방 골기시부 파열에 대한 빈도를 조사하였고, 파열에 영향을 미칠 수 있는 요인에 대하여 분석하였다. 대상 및 방법: 2008년 1월부터 2009년 6월까지 슬관절염으로 인공 슬관절 전 치환술을 시행 받고 내측 반월상 연골판 후방 골기시부의 파열 유무를 조사받은 173명 258예를 대상으로 하였다. 평균 연령은 68.8세(50∼87세)였고 남자가 23명(28예), 여자가 150명(230예)이었다. 연령, 성별, 체질량 지수(BMI), Kellgren-Lawrence에 따른 골관절염의 정도, 외상의 유무, 좌우 빈도 및 내반 변형의 정도 등을 조사하여 통계적으로 분석하였다. 결과: 내측 연골판 후방 골기시부 파열은 258예 중 182예(70.5%)에서 관찰되었고, 남자가 28예 중 18예 (64.2%), 여자가 230예 중 164예(71.3%)였으며 통계적 유의성은 없었다(p=0.102). 골관절염의 정도 (p=0.040) 및 내반 변형의 정도와 파열의 비율은 통계적으로 유의한 값(p=0.030)을 보였고, 체질량 지수, 외상의 유무 및 좌우의 관계와 파열은 유의성이 없었다(p>0.05). 결론: 인공 슬관절 전 치환술시 관찰된 내측 연골판 후방 골기시부 파열은 골관절염의 정도 및 내반 변형과 연관성이 있는 것으로 보이나, 퇴행성 관절염의 선행 원인인가에 대한 더 많은 연구가 필요할 것이다. Purpose: We examined the incidence of root tear of the medial meniscus posterior horn among patients who had undergone total knee replacement and we analyzed the factors that cause this tear. Materials and Methods: We enrolled 258 knees of 173 patients who had undergone total knee replacement from January 2008 to June 2009. The mean age was 68.8 (range: 50∼87). There were 23 men (28 cases) and 150 women (230 cases). We performed statistical correlation analysis between the assumed causes of meniscal tears (age, gender, grade of osteoarthritis, the predisposition site, BMI and varus deformity) and root tears. Results: Meniscal tears were observed in 182 cases (70.5%), and there were 18 cases (64.2%) of 28 cases and 164 cases (71.3%) of 230 cases in the men and women, respectively. Root tear had correlation with the severity of osteoarthritis (p=0.040) and varus deformity (p=0.030), but other underlying factors didn`t show significant correlation (p>0.05). Conclusion: Root tears of the medial meniscus posterior horn in total knee arthroplasty were related to the severity of osteoarthritis and varus deformity, but active interventions are required whether or not there are predisposing factors that cause osteoarthritis.

동종 반월상 연골 이식 후 이차 관절경 소견 및 MRI를 이용한 임상적 결과

전재균 ( Je Gyun Chon ),송인수 ( In Soo Song ),김준범 ( Jun Beom Kim ),정현윤 ( Hyun Yoon Jeong ),이창수 ( Chang Soo Lee ) 대한슬관절학회 2009 대한슬관절학회지 Vol.21 No.1

목적: 동종 반월상 연골 이식술 후 이차 관절경 소견 및 자기공명영상을 통해 이식물의 변화를 관찰하고 그 임상적 결과를 보고하고자 하였다. 대상 및 방법: 1997년 7월부터 2007년 2월까지 동종 반월상 연골 이식술을 시행 받은 환자에서 이차 관절경 검사와 자기공명영상 추시가 가능하였던 25 예를 대상으로 하였다. 이 중 남자는 16명, 여자는 8명이었다. 3예는 자기공명영상 추시 없이 이차 관절경 검사만 시행하였다. 평균 연령은 36.1세, 평균 추시기간은 28.0개월(6.0개월∼7.0년)이었다. 이차 관절경 검사 시 2예에서는 조직검사를 시행하였다. 환자의 기능적 평가는 Lysholm score, Knee society score (KSS) system, The hospital for special surgery (HSS) knee score를 이용하였다. 결과: 이차 관절경 검사상 25예 중 23예에서 이식물이 변연부와 완전한 치유소견을 보였다. 25예 중 5예에서 후각부의 크기가 감소되어 있었다. 자기공명영상에서는 전 예에서 이차 관절경 검사와 일치된 소견을 보였다. Lysholm score는 술 전 평균 65.4점에서 술 후 평균 80.6점, Knee society score (KSS) system에서는 슬관절 점수가 평균 64.6점에서 평균 82.6점, 기능적 점수가 평균 70.2점에서 평균 85.6점, The hospital for special surgery (HSS) knee score에서는 평균 66.4점에서 평균 82.5점으로 향상되었다. 모든 기능 테스트에서 수술 후에 기능이 향상되었고, 이는 paired t-test로 평가되었다(p=0.000). 결론: 동종 반월상 연골 이식술은 이식된 연골이 주변조직과 함께 완전히 치유되었고 임상적으로도 호전되어 반월상 연골 결손환자의 치료에 유용한 방법이라고 생각되고, 임상적으로 문제가 있는 환자의 평가에 있어서는 MRI 검사 후 관절경술을 통한 확인이 필요하다고 생각된다. Purpose: The purpose of this study was to evaluate the clinical results and the changes of allogenic meniscal transplantation by using the second look arthroscopic findings and the MRI changes after surgery. Materials and Methods: From July 1997 to February 2007, among the patients that underwent allogenic meniscal transplantation, we chose 25 patients who underwent secondary arthroscopic evaluation. 16 of these 25 patients were men and 8 were women. Secondary arthroscopic evaluation was done without MRI in 3 cases. The mean age was 36.1 yr and the average follow up period was 28 months. Biopsy by the secondary arthroscopic evaluation was done in 2 cases. We evaluated the clinical results by the Lysholm knee scoring scale, the Knee Society Score (KSS) system and the Hospital for Special Surgery (HSS) knee score. Results: Second-look arthroscopy after allogenic meniscal transplantation revealed that 23 cases seemed normal at the probing procedure. 5 cases showed a decreased posterior horn size. The MRI findings and secondary arthroscopic findings matched in all cases. The clinical Lysholm score improved from preoperative 65.4 points to postoperative 80.6 points, the Knee Society Score (KSS) improved from preoperative 64.6 points to postoperative 82.6 points, the functional score improved from preoperative 70.2 points to postoperative 85.6 points and the Hospital for Special Surgery (HSS) knee score improved from preoperative 66.4 points to postoperative 82.5 points (p=0.000). The function after surgery improved on all the tests and this was proved by paired t-tests. Conclusion: Allogenic meniscal transplantation showed good results on the second look arthroscopy and the follow-up MRI and according to the clinical functional outcome. We think that confirmation through arthroscopy after follow-up MRI for the patients with clinical knee problems seems to be necessary.

청소년에서 성장판 손상을 최소화하는 전방십자인대 복원술 -수술 술기 보고-

전재균 ( Je Gyun Chon ),윤영필 ( Young Phil Yune ),이철형 ( Chul Hyung Lee ),강현석 ( Hyoun Suk Kang ),정현석 ( Hyeon Seok Jeong ),정현윤 ( Hyun Yoon Jeong ) 대한슬관절학회 2008 대한슬관절학회지 Vol.20 No.2

Substantial ACL ruptures are not common in adolescence or childhood. During this period, ACL tibia avulsion fractures are more common than substantial ACL ruptures are. However, recent advancements in MRI and increases in adolescent sports activity have led to increased diagnosis of substantial ACL ruptures. Many physeal-sparing ACL reconstruction methods have been reported. However, some physeal-sparing ACL reconstructions are associated with poor outcomes because of laxity in the reconstructed ligament and discordance in the isometric point. We report a 14-year-old male patient with a chronic substantial ACL rupture and a longitudinal medial meniscus tear who was treated with ACL reconstruction and all-inside meniscal repair, which spares the femoral physis and reduces tibia physeal injury with an Achilles allograft.